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Audits start to pile up

Dressings, orthotics, urological supplies, CGMs all under review

WASHINGTON - CGS, the DME MAC for jurisdictions B and C, will be conducting complex post-pay reviews for surgical dressings and knee orthoses, according to AAHomecare.

Noridian publishes review results


FARGO, N.D. – Noridian Healthcare Solutions, the Jurisdiction D DME MAC, has published the results of prepayment reviews for a number of products. Oxygen (E1390) had a potential improper payment rate of 31% from March 2015 through May 2015.

Contractors warn docs of DME scams


WASHINGTON – The DME MAC medical directors say they are fielding frequent complaints from doctors who are the targets of DME marketing schemes.

High denial rate for power wheelchairs


INDIANAPOLIS - National Government Services denied 79.8% of power wheelchair claims between Oct. 1 and Dec. 31 because paperwork failed to demonstrate beneficiaries’ needs, according to a recent bulletin.

In brief: CMS reports glitch, OIG reports overpayments


NASHVILLE, Tenn. – A problem with ordering/referring physician data in the DME MAC claim system is affecting processing, as well as the data available in the myCGS web portal and the Jurisdiction C IVR, according to a bulletin from CGS.

Cushions up for prepayment audit


NASHVILLE, Tenn. – CGS, the DME MAC for Jurisdiction C, will implement a prepayment edit for E2603 (skin protection wheelchair seat cushion, any depth, but less than 22 inches wide) and E2622 (adjustable skin protection wheelchair seat cushion, any depth, less than 22 inches wide).

Contractor warns of delays with paper claims


INDIANAPOLIS – National Government Services (NGS), the DME MAC for Jurisdiction B, is experiencing delays updating the optical character recognition system it implemented to process CMS-1500 paper claims.

DME MAC changes name


WASHINGTON – Noridian Administrative Services, the DME MAC for Jurisdiction D, has changed its name to Noridian Healthcare Solutions, the organization announced in a message to its mailing list.

Error rate hits 95% for diabetic shoes


WASHINGTON – Ninety-five percent of claims for therapeutic shoes for persons with diabetes were denied in the third quarter of 2012, according to a prepayment review conducted by National Government Services, the DME MAC for Jurisdiction B.